A 16-Year-Old Boy Is Evaluated Due to New-Onset Jaundice

A 16-year-old boy is evaluated due to new-onset jaundice.  The patient was admitted to the hospital 24 hours ago after an emergency appendectomy, as well as drainage and irrigation of the peritoneal cavity, due to a perforated appendicitis.  He has no chronic medical conditions.  Current medications are intravenous morphine and piperacillin-tazobactam.  The patient has not received blood products.  Temperature is 38.1 C (100.6 F) , blood pressure is 118/80 mm Hg, and pulse is 98/min.  On examination, there is mild scleral icterus.  Cardiopulmonary examination is normal.  The laparotomy site is mildly tender; there is no rigidity or rebound tenderness.  No drain was placed.  Laboratory results are as follows: Which of the following is the most likely diagnosis?

A) Acalculous cholecystitis
B) Deficiency of glucose-6-phosphate dehydrogenase
C) Deficiency of hepatic glucuronosyltransferase
D) Hypoperfusion-induced liver injury
E) Iatrogenic biliary injury
F) Liver injury due to an inhaled anesthetic

Correct Answer:

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